Researchers have developed an advanced tool capable of predicting an individual’s risk of heart disease based on their cumulative exposure to various risk factors. The tool, created by faculty members at the UM School of Medicine, enables early identification and assessment of risks in vulnerable patients.
Heart disease, the leading global cause of death, has spurred scientists to investigate the combined effects of multiple risk factors such as high blood pressure, obesity, and elevated cholesterol on the likelihood of experiencing a heart attack or stroke. Using advanced modeling techniques, researchers from the University of Maryland School of Medicine (UMSOM) have designed an innovative tool that predicts heart disease risk for individuals over the age of 40, considering their lifelong exposure to these risk factors.
Their groundbreaking study, recently published in the Journal of the American College of Cardiology, utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Over a span of three decades, CARDIA tracked nearly 5,000 healthy young adults from four cities in the US, providing researchers with valuable data to calculate the cumulative effects of individual risk factors like hypertension, diabetes, and high cholesterol. Additionally, the study measured the combined impact of multiple risk factors leading to cardiovascular disease.
The research revealed that Black patients have a 46 percent higher risk of developing heart disease compared to white patients, independent of other risk factors such as family history, smoking habits, and socioeconomic status. Black patients were also found to be more susceptible to the cardiovascular effects of uncontrolled high blood pressure, while white patients showed greater susceptibility to elevated low-density lipoprotein (LDL) levels.
“These findings emphasize the importance of implementing risk-factor reduction strategies as early in life as possible to minimize cumulative exposure to harmful risks,” stated study lead author Michael J. Domanski, MD, Professor of Medicine at UMSOM. “The results suggest that self-declared Black racial status is indicative of underlying and unexplained differences in the impact of risk factors.”
The study’s results have the potential to guide physicians in developing personalized prevention strategies for individual patients. Public health policymakers can also utilize the risk calculation tool to assess the potential impact of proposed heart disease prevention programs, while researchers can employ it to design clinical trials for testing prevention strategies.
Xin Tian, Ph.D., Adjunct Professor at UMSOM and a biostatistician at the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), stated, “By examining the long-term impact of multiple risk factors on cardiovascular disease, our study highlights the importance of cumulative exposure in determining an individual’s risk. Our findings underscore the need for personalized prevention strategies that address both the time course and severity of these risk factors. As scientists, it is our responsibility to utilize this knowledge to develop effective prevention and intervention strategies that can reduce the burden of cardiovascular disease on individuals and society as a whole.”
The study also introduced the R Shiny app, a tool enabling medical providers to input cardiovascular risks, patient history, and patient race to determine individual risks and develop appropriate strategies. With electronic medical records widely available, the development of such tools has become feasible. The R Shiny app hosted on the NHLBI’s website estimates cardiovascular risks after the age of 40 based on the severity of risk factors earlier in adulthood.
Colin Wu, Ph.D., Adjunct Professor of Medicine at UMSOM and a mathematical statistician at NHLBI, part of NIH, expressed, “Our study demonstrates the power of innovative statistical data-science approaches in enabling biomedical researchers to gain deeper insights into complex health issues, such as cardiovascular disease. We were able to develop risk prediction models that provide a more accurate and personalized assessment of an individual’s risk.”
During the two-decade follow-up period after the age of 40, the study observed that 316 people experienced their first cardiovascular event, including heart disease, strokes, and congestive heart failure.
“This new tool could be employed by cardiologists to encourage patients to take necessary steps in lowering their risk of heart attack or stroke. It quantifies how much their risk would improve with better management of factors like cholesterol and hypertension,” explained Mark Gladwin, MD, Dean of the University of Maryland School of Medicine and Vice President for Medical Affairs at the University of Maryland, Baltimore. “This could have a significant impact, especially on vulnerable populations who haven’t received adequate treatment for cardiovascular risks in the past due to long-standing health inequities.”
Reference: “Association of Incident Cardiovascular Disease With Time Course and Cumulative Exposure to Multiple Risk Factors” by Michael J. Domanski, Colin O. Wu, Xin Tian, Ahmed A. Hasan, Xiaoyang Ma, Yi Huang, Rui Miao, Jared P. Reis, Sejong Bae, Anwar Husain, David R. Jacobs, Norrina B. Allen, Mei-Ling T. Lee, Charles C. Hong, Michael E. Farkouh, Donald M. Lloyd-Jones and Valentin Fuster, 20 March 2023, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2023.01.024
The CARDIA data used in this research is supported by NHLBI in collaboration with the University of Alabama at Birmingham, Northwestern University, University of Minnesota, and the Kaiser Foundation Research Institute.
Table of Contents
Frequently Asked Questions (FAQs) about cardiovascular disease risk prediction tool
What is the purpose of the cardiovascular disease risk prediction tool?
The purpose of the cardiovascular disease risk prediction tool is to accurately assess an individual’s risk of developing heart disease based on their cumulative exposure to various risk factors such as high blood pressure, obesity, and high cholesterol. It aids in the early identification of risks and enables the development of personalized prevention strategies.
How does the tool work?
The tool utilizes advanced modeling techniques and data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to calculate the combined effects of individual risk factors and measure the additive impact of multiple risk factors leading to cardiovascular disease. It takes into account factors like hypertension, diabetes, and high cholesterol to predict an individual’s risk of heart disease after the age of 40.
What are the key findings of the research?
The research found that Black patients have a 46 percent higher risk of developing heart disease compared to white patients, independent of other risk factors. Black patients were also more susceptible to the cardiovascular effects of uncontrolled high blood pressure, while white patients showed greater susceptibility to elevated low-density lipoprotein (LDL) levels. These findings emphasize the need for personalized prevention strategies and highlight underlying differences in risk-factor impact.
How can the tool be used in healthcare?
The tool can be used by healthcare providers, particularly cardiologists, to assess an individual’s risk of heart disease and develop personalized prevention strategies. It can also aid public health policymakers in evaluating the potential impact of heart disease prevention programs. Additionally, researchers can utilize the tool to design clinical trials aimed at testing prevention strategies and interventions.
What is the significance of the R Shiny app mentioned in the text?
The R Shiny app is a tool developed in the study that allows medical providers to input cardiovascular risks, patient history, and patient race to determine individual risks and develop appropriate strategies. It provides a more accurate and personalized assessment of an individual’s risk of heart disease after the age of 40 based on the severity of risk factors earlier in adulthood. The app can be accessed on the National Heart, Lung, and Blood Institute’s (NHLBI) website.
More about cardiovascular disease risk prediction tool
- Journal of the American College of Cardiology: Association of Incident Cardiovascular Disease With Time Course and Cumulative Exposure to Multiple Risk Factors
- University of Maryland School of Medicine: Press Release
- National Heart, Lung, and Blood Institute (NHLBI): R Shiny App
